One day right before Christmas, I got a call from a man in his early 30s about coming in for therapy. He explained that he wanted to figure out whether to marry his girlfriend, and he hoped we could “resolve this” quickly because Valentine’s Day was coming up and he knew he either had to produce a ring or she’d bail. I explained that I could help him with clarity but couldn’t guarantee his timeline. The day before our appointment, he called again and told me he found a relationship coach to help sort things out. She gave him a four-session-package guarantee.

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I remembered something that Casey Truffo told me. A few years ago, she was at a business-networking event and wrote “psychotherapist” on her name tag; nobody wanted to talk to her. At the next event, she wrote the words “happiness locator” and got several referrals. In the past, going to a life coach might have seemed tantamount to a snake-oil cure, but now psychotherapists were branding themselves to play down what they do and what credentials they hold. I added up the money spent on grad school, the years it would take to pay off the loans, the time spent on training, the commitment to helping people that brings most of us into the field in the first place, and I knew I wasn’t willing to leave. My only choice now was how far I would go in order to stay.